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PubMed1979

[A caloric vestibular test with increased positive evidence (author's transl)].

A decrease of the variance of a caloric test would increase the importance of the statement of this test. An important source of variance are the differences concerning the timecourse of the induced heat wave, determined by the different anatomic conditions in the petrous bone, particularly the pneumatisation. A constant temperature gradient is obtained by the irigation in a pessimum position with the head flexed 30 degrees to the front. This temperature gradient evokes immediately a constant maximum vestibular stimulus after having reflected the head 90 degrees to the back. Comparing this new method with the traditional irrigation, one can state an important reduction of variance. The dependence of the nystagumus response on caloric irrigation of the petrous bone demands a X-ray-examination according to the technique of Schüller before starting with the caloric examination. In case of differences between the right and left sides the described test would be necessary in our opinion.

Caloric Tests↗
PubMed1979

Inverted caloric nystagmus by warm air stimulation.

The rather frequent appearance of an inverted nystagmus, when stimulating with warm air for caloric testing, is emphasized. It is clearly demonstrated that this nystagmus is a real caloric one, but beating in the opposed direction. Its occurrence in many cases, especially when an active middle ear pathology is present, diminishes the reliability of this air stimulation technique, as it is especially indicated in these cases.

Air↗
PubMed1977

Comprehensive presentation of semicircular canal sensitivity.

It is generally agreed that in order to determine any difference in vestibular sensitivity between the two inner ears, the best clinical procedure involves a quantitative expression of the slow phase nystagmus response to standardized caloric (or rotatory) stimulation. The preferred procedure has involved averaging the slopes of a few of the nystagmus responses during the period of most intense activity and this has been accomplished either arithmetically or by means of an electronic computer. Although, such a sampling is often sufficient to enable a reliable diagnosis, occasions do arise when the results can be misleading unless comprehensive total presentations of the responses from the two labyrinths are available for reliable comparative evaluation. Such a procedure has been developed at the University of Toronto and used for clinical assessment at St. Michael's Hospital. The reliability of the method has been established as the result of testing over 800 patients with various vestibular disorders.

Caloric Tests↗
PubMedDate not supplied

[Dissociation of vestibular autonomic and sensory reactions].

The studies of healthy people and test subjects with vestibular reception disorders yielded data about relative independence of the vestibulo-autonomic and vestibulo-sensory reactions during routine vestibulometric and tilt tests. The subjects with a changed labyrinthine function showed a higher vestibulo-autonomic stability as compared to those with normal hearing. In both groups the sensory component of vestibular reactions did not differ significantly. Hemodynamic changes were found to modify some parameters of the nystagmic reactions.

Adolescent↗
PubMed1987

[A vestibular model of the course of Menière's disease].

Based on directional preponderance (DP) of the caloric nystagmus of 36 patients with Ménière's disease (MD), 57 calorigrams are divided in three groups: with ipsilateral, contralateral and without DP (neutral). Each calorigram is an unique moment in the course of MD. The age of the patient at that moment, the time since the first symptoms and since the last vertiginous spell, as well as the percentages of caloric response reduction and of DP are recorded. There are significant (Mann-Whitney U-test) differences between duration of the MD, time since the last spell and DP of the ipsilateral group and the same items of the contralateral group. Ipsilateral and contralateral calorigrams become neutral, consequently the neutral group is complex. From a vestibular point of view, MD is characterized by stages with a cyclic interrelation: during the first four years, ipsilateral stages with periferal stimulation or reversible reduction with recovery; one year after the first symptoms, contralateral stages with (partial) loss of function with central compensation; neutral stages--with or without minor spells--without further loss of function. Staging MD is of diagnostic importance; perhaps different stages need a different therapy. Stimulation or reversible loss of function in an ipsilateral stage is probably not caused by hydrops; in a contralateral stage with definite loss of function hydrops could be involved.

Adult↗